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Early Prenatal Care – How Can We Get the Numbers Higher?

Early Prenatal Care – How Can We Get the Numbers Higher?

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Monday, April 1, 2013

Herkimer and Oneida Counties Community Indicators have just updated data on early prenatal care. This is the kind of cause most everyone can get behind – who wouldn’t want more pregnant women getting timely care for themselves and their growing babies? Yet, the numbers have proven hard to move. This might change if the Supreme Court upholds national health reform and its mandate to carry health insurance, but studies suggest having health insurance isn’t the only factor.

The nation had set a goal for 2010: 90% of pregnant women getting care in the first trimester of pregnancy. In New York and in Herkimer and Oneida counties, we’re not close: in 2010, 79% of mothers in Herkimer and 71% in Oneida started prenatal care that early.[1] Generally speaking, rates of early access to prenatal care haven’t changed much over the past decade, and neither have rates of problems that prenatal care helps prevent, such as low birth weight. Even more troubling, low-income and minority women tend to be less likely to start care early, another stubborn pattern.

Over the past decade, New York has expanded health insurance by making more people eligible for Medicaid, but that’s only filled in a gap left by employment-based insurance. The share of residents receiving insurance through work dropped from 63% in 2000 to 57% in 2010. The share covered by Medicaid increased by the same margin, from 14% to 20% (not necessarily the same people, of course) – leaving our overall share of residents without insurance stable at about 15%[2].

It’s easy to imagine that expanding health insurance will lead to more mothers getting early care, and some research backs this up. A study of insurance expansion in the 1990s in California found rates of early prenatal care increased from 73% to 84%.[3] Yet other research has pointed to different factors, including women’s education levels, their attitudes toward their pregnancies, lack of regular health care before their pregnancies, and transportation problems.[4] Moving this indicator may require multiple approaches at both the national/state and local levels, with communities wrestling with how to reach women who for many different reasons are not inclined to seek early care for themselves.

Learn more about the health status of Herkimer and Oneida residents and early prenatal care.